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The Coronavirus Pandemic Disrupts Opioid Addiction Treatments In Philadelphia

AILSA CHANG, HOST:

Before the coronavirus, the biggest health crisis on the minds of many city officials and public health experts was the opioid epidemic. Philadelphia has the highest overdose rate of any big city in America. While the pandemic might have eclipsed the conversation around the opioid crisis, it's only made life harder for those struggling with addiction. WHYY's Nina Feldman reports.

NINA FELDMAN, BYLINE: Most mornings, before the city shut down, Ed would head into a nearby McDonald's to brush his teeth, wash his face and buy a cup of coffee when he could. He would bounce between shelters and try to get a shower in. But once the pandemic hit Philadelphia, businesses and shelters closed. He even tried to get into treatment, but they weren't taking new people.

ED: I'll be honest, man. I really don't sleep too much, man. You know, like, every four or five days, I'll get a couple hours.

FELDMAN: He's still living on the streets and struggling with addiction, which is why we aren't using his last name.

ED: I stay with friends that are also in my situation. We - they've got some tents set up down on the train tracks - nice little setup.

FELDMAN: People in Ed's situation are exactly who Rosalind Pichardo wants to help. Before the pandemic, Pichardo would hit the streets of Philadelphia's Kensington neighborhood with a bag full of Narcan, the opioid overdose reversal drug.

UNIDENTIFIED PERSON #1: Thousand crystals, thousand crystals, thousand crystals, thousand crystals...

FELDMAN: She'd hand it out to people using drugs, selling drugs, anyone who wanted it.

ROSALIND PICHARDO: You good? You need some Narcan?

UNIDENTIFIED PERSON #2: (Unintelligible) You never know.

FELDMAN: At her last count, Pichardo had personally reversed almost 400 overdoses.

PICHARDO: Thank you, love.

UNIDENTIFIED PERSON #2: Thank you.

PICHARDO: I'll see you around.

UNIDENTIFIED PERSON #2: You stay safe.

PICHARDO: Yep. You, too.

I remember saving him.

FELDMAN: Really?

PICHARDO: Yeah, in front of the storefront.

FELDMAN: When the stay-at-home order went into effect, Pichardo and others knew that would mean more people using alone and fewer first responders out on the street to revive them if they overdosed. So they gave out even more Narcan. The nation's largest syringe exchange, Prevention Point, said that for the first month of Philadelphia's stay-at-home order, it handed out almost twice as much Narcan as usual. Philly's fatal overdose rate during the pandemic is about what it was this time last year. Pichardo worries that with all the Narcan on the streets, that just means people are using more.

On a recent day, she says she reversed three people who'd overdosed while two police officers stood by and watched.

PICHARDO: I don't know. I guess they got their hands full with crime or whatever. I don't expect them to give them rescue breaths if they don't want to. But at least administer the lifesaving drug. There's a social distance to a limit. I think when someone's life is in jeopardy that they're worth saving. You know what I mean? Like, you just can't watch people die.

FELDMAN: For those who are ready to give recovery a try, loosened federal restrictions make medications that curb opioid cravings and stem withdrawal easier to get. A group of volunteers is giving cell phones to people coming out of jail so they can be prescribed those drugs using telehealth. And now they can renew their prescriptions every month instead of every week to decrease traffic at the pharmacy.

Ben Cocchiaro is a doctor who treats people with substance use disorder.

BEN COCCHIARO: So if we find that these relaxed restrictions are bringing more people to the table, then that presents enormous ethical questions about whether or not the DEA should reinstate these restrictive policies that they had going in the first place.

FELDMAN: Cocchiaro says the whole point of addiction treatment is to make help easy to get as soon as someone is ready for it. He hopes if we can make it happen in a pandemic, we can afterwards, too.

For NPR News, I'm Nina Feldman in Philadelphia.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.